Changes in self-reported cannabis use in the United States from 1979 to 2022.
Level 3 - non-randomized controlled study
Secondary analysis of serial cross-sectional national survey cohorts.
PubMed 38775461 · doi:10.1111/add.16519
What was done
Secondary analysis of 27 United States national general population surveys (the National Survey on Drug Use and Health and its predecessors) spanning 1979 to 2022 (total n = 1,641,041). The authors tracked rates of cannabis use and total reported days of use, comparing them to alcohol consumption across four policy benchmark years: 1979, 1992, 2008, and 2022.
What was found
Reported cannabis use reached a nadir in 1992, increased moderately through 2008, and grew substantially thereafter. Between 2008 and 2022, per capita past-year cannabis use increased by 120%, and per capita days of use increased by 218% (from 2.3 to 8.1 billion days annually). From 1992 to 2022, per capita daily or near-daily use increased 15-fold. In 2022, daily and near-daily cannabis users outnumbered daily and near-daily alcohol drinkers for the first time (17.7 million vs. 14.7 million). While overall drinking remained more common, in 2022 median past-month cannabis consumers reported use on 15–16 days (vs. 4–5 days for drinkers) and were 7.4 times more likely to report daily use (28.2% vs. 3.8%).
Why it matters
This study documents a major epidemiological shift in United States substance use patterns, showing that high-frequency cannabis use has escalated dramatically over three decades and now surpasses high-frequency alcohol use in absolute numbers.
Limits
Relies on self-reported survey data, which is vulnerable to recall and social desirability biases that may have evolved as cannabis became legal and less stigmatized. The abstract provides no data on product potency, modes of administration, or clinical cannabis use disorder rates.